1
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Patil D, Tang H, Kuo F, Toh HS, Yang I, Chang W, Lee M, Chung K, Huang C, Hsu W, Chang T, Shih J, Liao C. Assessing the diversity and determinants of health-related quality of life measures in patients with acute heart failure. ESC Heart Fail 2024; 11:1963-1970. [PMID: 38509031 PMCID: PMC11287333 DOI: 10.1002/ehf2.14745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/04/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
AIMS Heart failure with reduced ejection fraction (HFrEF) significantly impacts health-related quality of life (HR-QoL). Existing HR-QoL questionnaires can show inconsistencies, potentially misrepresenting patient self-reports. This study examines the variation in HR-QoL measurement tools for HFrEF patients, identifying related determinants. METHODS AND RESULTS We retrospectively analysed 134 hospitalized patients with acute decompensated HFrEF at a Taiwanese tertiary centre's Heart Failure Post-Acute-Care (HF-PAC) programme. Participants completed the EuroQol-5 dimension (EQ-5D) questionnaire, the EQ-5D visual analogue scale (VAS), and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Utility values were obtained from the EQ-5D questionnaire. Demographic features were depicted using descriptive statistics, while multivariate regression was used to ascertain relationships between HR-QoL measurements and determinants. Average scores for EQ-5D, MLHFQ, EQ-5D utility, and VAS were 6.1 ± 1.6, 21.8 ± 21.3, 81.7 ± 27.0, and 59.5 ± 14.6, respectively. Significant correlations were observed among the three tools. The New York Heart Association functional class showed a notable association with all tool scores. Other associations encompassed EQ-5D with coronary artery disease, mineralocorticoid receptor antagonists, and the 6 min walk test; EQ-5D VAS with chronic kidney disease; and MLHFQ with age. CONCLUSIONS This study illuminates the variance in HR-QoL measurement tools for Taiwanese HFrEF patients. Using a range of these tools is beneficial in unveiling diverse determinants and approaching comprehensive patient-centred care. However, for a more precise HR-QoL assessment in Taiwanese HFrEF patients, recalibrating the EQ-5D-derived utility scores might be necessary, emphasizing the importance of patient-specific considerations within the HF-PAC programme.
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Affiliation(s)
- Dhrumil Patil
- Baroda Medical CollegeVadodaraIndia
- World Youth Heart FederationVadodaraIndia
| | - Hsin‐Ju Tang
- Department of NursingChang Gung University of Science and Technology, Chronic Diseases and Health Promotion Research CenterChiayiTaiwan
| | - Fang‐Hsiu Kuo
- Division of Cardiology, Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
| | - Han Siong Toh
- Department of Intensive Care MedicineChi Mei Medical CenterTainanTaiwan
- Institute of Clinical Medicine, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Health and NutritionChia Nan University of Pharmacy and ScienceTainanTaiwan
| | - I‐Ning Yang
- Division of Nephrology, Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
- Institute of Clinical Pharmacy and Pharmaceutical SciencesNational Cheng Kung UniversityTainanTaiwan
| | - Wei‐Ting Chang
- Division of Cardiology, Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
| | - Mei‐Chuan Lee
- Department of PharmacyChi Mei Medical CenterTainanTaiwan
- Department of Public Health, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Kai‐Ning Chung
- Division of Cardiology, Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
| | - Chi‐Ya Huang
- Division of Nephrology, Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
| | - Wan‐Hsuan Hsu
- Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
| | - Ting‐Chia Chang
- Division of Chest Medicine, Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
| | - Jhih‐Yuan Shih
- Division of Cardiology, Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
- Department of Health and NutritionChia Nan University of Pharmacy and ScienceTainanTaiwan
| | - Chia‐Te Liao
- Division of Cardiovascular MedicineChi Mei Medical Center, School of Medicine, College of Medicine, National Sun Yat‐sen UniversityKaohsiungTaiwan
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2
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Vieira MC, Mendes FDSNS, da Silva PS, da Silva GMS, Mazzoli-Rocha F, de Sousa AS, Saraiva RM, Quintana MDSB, Costa HS, Paravidino VB, Rodrigues LF, Hasslocher-Moreno AM, Americano do Brasil PEA, Mediano MFF. The association between variables of cardiopulmonary exercise test and quality of life in patients with chronic Chagas cardiomyopathy (Insights from the PEACH STUDY). PLoS One 2022; 17:e0279086. [PMID: 36520825 PMCID: PMC9754173 DOI: 10.1371/journal.pone.0279086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Studies investigating the association between functional capacity and quality of life (QoL) in individuals with chronic Chagas cardiomyopathy (CCC) usually do not include a gold-standard evaluation of functional capacity, limiting the validity and the interpretation of the results. The present study is a cross-section analysis aiming to evaluate the association between functional capacity (quantified by cardiopulmonary exercise test [CPET]) and QoL in individuals with CCC. QoL was assessed using the SF-36 questionnaire. Sociodemographic, anthropometric, clinical, cardiac function and maximal progressive CPET variables were obtained from PEACH study. Generalized linear models adjusted for age, sex, and left ventricular ejection fraction were performed to evaluate the association between CPET variables and QoL. After adjustments, VO2 peak and VO2 AT were both associated with physical functioning (β = +0.05 and β = +0.05, respectively) and physical component summary (β = +0.03 and β = +0.03, respectively). Double product was associated with physical functioning (β = +0.003), general health perceptions (β = +0.003), physical component summary (β = +0.002), and vitality (β = +0.004). HRR≤12bpm was associated with physical functioning (β = -0.32), role limitations due to physical problems (β = -0.87), bodily pain (β = -0.26), physical component summary (β = -0.21), vitality (β = -0.38), and mental health (β = -0.19). VE/VCO2 slope presented association with all mental scales of SF-36: vitality (β = -0.028), social functioning (β = -0.024), role limitations due to emotional problems (β = -0.06), mental health (β = -0.04), and mental component summary (β = -0.02). The associations between CPET variables and QoL demonstrate the importance of CPET inclusion for a more comprehensive evaluation of individuals with CCC. In this setting, intervention strategies aiming to improve functional capacity may also promote additional benefits on QoL and should be incorporated as a treatment strategy for patients with CCC.
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Affiliation(s)
- Marcelo Carvalho Vieira
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | | | - Paula Simplício da Silva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andrea Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Henrique Silveira Costa
- Department of Physical Therapy, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Vitor Barreto Paravidino
- Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Physical Education and Sports, Naval Academy, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiz Fernando Rodrigues
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Physiological Sciences, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Rio de Janeiro, Brazil
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3
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Zhang J, Liu M, Hu B, Wang L. Exercise Combined with a Chinese Medicine Herbal Tea for Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:878-886. [PMID: 36037014 DOI: 10.1089/jicm.2022.0580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objectives: Exercise and Traditional Chinese Medicine (TCM) herbal tea may improve glucose metabolism through quite different mechanisms while sharing some common effects. The purpose of this study was to discover whether the intervention of exercise combined with TCM herbal tea intervention could produce advanced improvement in glucose metabolism than exercise alone in community patients with type 2 diabetes mellitus (T2DM). Materials and Methods: This was a 12-week, randomized controlled trial in which 75 community patients with T2DM were randomly assigned to the single group (n = 39) receiving intervention of aerobic and resistance exercise three times per week and the combined group (n = 36) receiving intervention of TCM herbal tea (consisted of six substances) taken once daily besides the exercise. The change of glycated hemoglobin A1 (HbA1c), tested before and after intervention, served as the primary outcome. Other measurements include fasting plasma glucose (FPG), glycated serum protein (GSP), lipid profile, and physical fitness profile. Results: HbA1c and FPG levels and their changes showed no group difference. The level of GSP was lower, and its decrease was also larger after exercise combined with TCM herbal tea than after single exercise intervention (p < 0.05). Lipid profile and physical fitness parameters were similar in the two groups except the larger six-minute walk test (6MWT) power after the combined intervention (p < 0.05). Patients showed good compliance with the intervention and had similar exercise days or amount in the two groups. No patient reported serious adverse events or significant changes in other lifestyles. Conclusions: A 12-week of exercise combined with TCM herbal tea could not enhance the hypoglycemic effects by exercise alone in community patients with type 2 diabetes. However, the lower GSP level and larger 6MWT work brought by combined intervention suggest its potential benefits, and further studies are needed to explore the effects of longer period and larger dosage of intervention. Clinical Trial Registration Number: Chinese Clinical Trial Registry: ChiCTR1800018721.
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Affiliation(s)
- Jiajia Zhang
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Minjing Liu
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Biyue Hu
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Li Wang
- School of Nursing, Medical College, Soochow University, Suzhou, China
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4
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Almeida ILGID, Oliveira LFLD, Figueiredo PHS, Oliveira RDDB, Damasceno TR, Silva WT, Oliveira LFFD, Ávila MR, Lima VP, Lages ATC, Mediano MFF, Rocha MOC, Costa HS. The health-related quality of life in patients with Chagas disease: the state of the art. Rev Soc Bras Med Trop 2022; 55:e0657. [PMID: 35293550 PMCID: PMC8932319 DOI: 10.1590/0037-8682-0657-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/15/2022] [Indexed: 12/30/2022] Open
Abstract
Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.
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Affiliation(s)
| | | | - Pedro Henrique Scheidt Figueiredo
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil.,Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Rafael Dias de Brito Oliveira
- Universidade Federal de Minas Gerais, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Belo Horizonte, MG, Brasil
| | - Thayrine Rosa Damasceno
- Universidade Federal de Minas Gerais, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Belo Horizonte, MG, Brasil
| | - Whesley Tanor Silva
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil
| | | | - Matheus Ribeiro Ávila
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Vanessa Pereira Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil.,Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Ana Thereza Chaves Lages
- Universidade Federal de Minas Gerais, Curso de Pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | | | - Manoel Otávio Costa Rocha
- Universidade Federal de Minas Gerais, Curso de Pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Henrique Silveira Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Diamantina, MG, Brasil.,Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
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5
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The prospects for NT-pro BNP level determining in physical activity conditions in patients during the rehabilitation period after the myocardial infarction, complicated with decompensated heart failure. EUREKA: HEALTH SCIENCES 2021. [DOI: 10.21303/2504-5679.2021.001793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of the study was to determine the futility of NT-pro BNP level analysis during dosed physical exercise for diagnosing decompensated HF in the postinfarction period and the possibility to determine the HF functional class.
Materials and methods. 160 patients with previous MI were examined, patients’ average age was (56.67±5.72) years. The patients were randomized in 2 groups dependently on the presence of the signs of II А-B according to V. Kh. Vasylenko and M. D. Strazhesko classification and FC III-IV (according to NYHA) decompensated chronic HF. Group I consisted of 120 patients with Q-QS and non-Q MI; group II (the control one) had 40 patients with MI without signs of decompensated HF; 20 healthy people made up a norm group.
Results. Signs of coronary insufficiency such as dizziness and signs of poor peripheral perfusion (cyanosis/paleness) occurred in 104 (86.7 %) and 79 (65.8 %) cases that differ from the same values in the second group 4 (10.0 %) and 14 (35.0 %) respectively. 88 (73.3 %) patients with the signs of decompensated HF felt general weakness, fatigue, and expressed a request to stop the test.
The HR in the postinfarction patients with the signs of decompensated HF was before the exercise (88.2±3.18) bpm (p≤0.05); in the patients with past MI without the signs of decompensated HF, it was (75.32±3.41) bpm (p≤0.05); and in the practically healthy people, it was (77.73±3.02) bpm. We found out a reverse moderate correlation between the distances that had been covered by a patient during the 6MWT NT-proBNP level in blood serum of examined patients.
Conclusions. Inadequate response to dosed physical exercises and increased immunological parameters as quantitative HF markers could be useful not only for diagnostics, but also for the risk stratification for decompensated HF that had occurred in patients on different rehabilitation stages after an acute MI.
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6
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Baldoni NR, Quintino ND, Alves GCS, Oliveira CDL, Sabino EC, Ribeiro ALP, Cardoso CS. Quality of life in patients with Chagas disease and the instrument used: an integrative review. Rev Inst Med Trop Sao Paulo 2021; 63:e46. [PMID: 34161552 PMCID: PMC8216686 DOI: 10.1590/s1678-9946202163046] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/08/2021] [Indexed: 01/06/2023] Open
Abstract
Chagas disease (CD) is a neglected tropical highly morbid disease that can have a negative impact on the quality of life (QoL). The purpose of this study was to conduct an integrative review to analyze the QoL of patients with CD in the chronic phase of the disease, as well as the instruments used and the effect of different interventions. The review was carried out based on the criteria and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guideline (PRISMA) using the PubMed, Scopus, Web of Science and Science Direct databases. An analysis of the reference list of the included articles was also carried out. Publications in all languages have been included. Two independent reviewers selected the eligible articles and extracted the data. A total of 1,479 articles were identified, and after applying the inclusion criteria 18 articles were included. Four different instruments were used to assess QoL and the most used was the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) [33.3% (n = 6)]. Investigations involving intervention showed a positive impact on the patients' QoL, and the Environment domain had the lowest score. Heterogeneity of instruments and lack of methodology standardization for assessing QoL was observed. QoL proved to be an important indicator for the planning and monitoring of patients with CD, however it is suggested that the instruments for its assessment should be the ones recommended by the validation studies. This process will allow the comparison of data between investigations.
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Affiliation(s)
| | | | | | | | - Ester Cerdeira Sabino
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
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7
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Ávila MR, Figueiredo PHS, Lima VP, Silva WT, Vianna MVA, Fernandes LHC, de Azevedo ACA, Lima MMO, de Carvalho Bastone A, do Carmo Pereira Nunes M, Mediano MFF, da Costa Rocha MO, Costa HS. Accuracy of health-related quality of life in identifying systolic dysfunction in patients with Chagas cardiomyopathy. Trop Med Int Health 2021; 26:936-942. [PMID: 33864407 DOI: 10.1111/tmi.13590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Systolic dysfunction is a well-established marker of mortality in patients with Chagas cardiomyopathy (CC). However, its diagnosis is expensive and useful tools for screening these patients are required. The evaluation of the health-related quality of life (HRQoL) detects the patient's perception of the disease's impact. However, its accuracy in identifying patients with CC and systolic dysfunction is unknown. The study aimed to verify the sensitivity, specificity and predictive values of the physical and mental components related to HRQoL in identifying patients with CC and systolic dysfunction. METHODS 75 patients with CC, aged 49 (95% confidence interval: 47-51) years, were evaluated by echocardiography and Short-Form of Health Survey (SF-36) questionnaire. Systolic dysfunction was defined by left ventricular ejection fraction <52% for men and <54% for women and left ventricular diastolic diameter >55 mm. RESULTS Most patients (73%) had systolic dysfunction, with lower HRQoL values in the physical functioning, physical role functioning and general health perceptions domains and in the physical component summary. The accuracy of identifying patients with systolic dysfunction by the scores of physical components was 73% and 62% of mental components. The optimal cut-off point was 46 for physical and 54 for mental components, with respective positive predictive values of 91% and 80%. CONCLUSION The evaluation of the HRQoL by the SF-36, a low-cost instrument, can be useful in identifying patients with systolic dysfunction, assisting in the screening and risk stratification of patients.
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Affiliation(s)
- Matheus Ribeiro Ávila
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Vanessa Pereira Lima
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Whesley Tanor Silva
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Marcus Vinícius Accetta Vianna
- Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Laís Helena Carvalho Fernandes
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Alda Cristina Alves de Azevedo
- Postgraduate Program in Infectious Diseases and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Márcia Maria Oliveira Lima
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Alessandra de Carvalho Bastone
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Maria do Carmo Pereira Nunes
- Postgraduate Program in Infectious Diseases and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Manoel Otávio da Costa Rocha
- Postgraduate Program in Infectious Diseases and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Henrique Silveira Costa
- Physical Therapy School, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
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8
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Ogawa A, Shimizu K, Nakagami T, Maruoka H, Shirai K. Physical Function and Cardio-Ankle Vascular Index in Elderly Heart Failure Patients. Int Heart J 2020; 61:769-775. [PMID: 32684606 DOI: 10.1536/ihj.20-058] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The number of heart failure patients is increasing rapidly in Japan because of its large elderly population. As age increases, arterial stiffness and physical dysfunction progress. This study aimed to evaluate the association between the physical function and arterial stiffness in elderly heart failure patients.This retrospective, observational study includes data from 100 heart failure patients aged ≥ 65 years who were admitted to our hospital and underwent cardiac rehabilitation. The Cardio-Ankle Vascular Index (CAVI) was measured as an indicator of arterial stiffness. Body composition was assessed by bioelectrical impedance analysis. To determine the degree of physical function, we assessed handgrip strength, five-meter walk speed (5MWS), five-repetition sit-to-stand time (5RSST) and six-minute walk distance (6MWD). Sarcopenia was defined using Asian guidelines based on physical function and body composition.Among 100 patients, 47.0% of patients had sarcopenia. After adjustments for age, sex, atrial fibrillation, and ischemic cardiomyopathy, CAVI was significantly higher in with sarcopenia patients than those without sarcopenia. Age, handgrip strength, 5MWS, 5RSST, and 6MWD were associated with CAVI, and 6MWD was as an independent determinant factor of CAVI.6MWD was recognized as an accurate physical function indicator. These findings suggested that physical function and arterial stiffness complement each other. To restore cardiac dysfunction, improving both arterial stiffness and physical function might be useful.
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Affiliation(s)
- Akihiro Ogawa
- Department of Rehabilitation, Sakura Medical Center, Toho University.,Graduate Course of Health and Social Services, Saitama Prefectural University
| | - Kazuhiro Shimizu
- Department of Internal Medicine, Sakura Medical Center, Toho University
| | - Takahiro Nakagami
- Department of Internal Medicine, Sakura Medical Center, Toho University
| | - Hiroshi Maruoka
- Graduate Course of Health and Social Services, Saitama Prefectural University
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9
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Costa HS, Lima MMO, Figueiredo PHS, Lima VP, Ávila MR, de Menezes KKP, Mendonça VA, Lacerda ACR, Nunes MCP, Mediano MFF, Rocha MODC. Exercise tests in Chagas cardiomyopathy: an overview of functional evaluation, prognostic significance, and current challenges. Rev Soc Bras Med Trop 2020; 53:e20200100. [PMID: 32638887 PMCID: PMC7341832 DOI: 10.1590/0037-8682-0100-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/21/2020] [Indexed: 12/19/2022] Open
Abstract
Patients with Chagas cardiomyopathy (ChC) usually progress with fatigue and dyspnea. Exercise tests are valuable for the functional evaluation of these patients. However, information about the applicability of the exercise tests is scattered, and no studies have systematically reviewed the results. Thus, the present review explored the general aspects and prognostic value of exercise tests in patients with ChC. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed to identify relevant studies. There were no data restrictions, and articles that met the objective of the study were selected. Articles written in English, Portuguese, and Spanish were considered, and 25 articles were finally included. The peak oxygen uptake (VO2peak) was correlated with demographic and echocardiographic variables. Echocardiographic features of the left ventricular diastolic function and right ventricular systolic function appeared to be determinants of functional capacity, in addition to age and sex. VO2peak was associated with higher mortality, especially in patients with dilated ChC. The minute ventilation/carbon dioxide production slope (VE/VCO2 slope) was a strong predictor of survival; however, more studies are needed to verify this observation. Field tests showed moderate to strong correlation with VO2peak and thus may be inexpensive tools for the functional evaluation of patients with ChC. However, few studies have verified their prognostic significance. While exercise tests are useful tools for functional assessment, information is scarce regarding further considerations, and many of the criteria are based on guidelines for other heart diseases.
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Affiliation(s)
- Henrique Silveira Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG,
Brasil
- Universidade Federal de Minas Gerais, Escola de Medicina, Curso de
pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Márcia Maria Oliveira Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG,
Brasil
- Universidade Federal de Minas Gerais, Escola de Medicina, Curso de
pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Pedro Henrique Scheidt Figueiredo
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG,
Brasil
| | - Vanessa Pereira Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG,
Brasil
| | - Matheus Ribeiro Ávila
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG,
Brasil
| | - Kenia Kiefer Parreiras de Menezes
- Universidade Federal de Minas Gerais, Escola de Educação Física,
Fisioterapia e Terapia Ocupacional, Curso de pós-graduação em Ciências da
Reabilitação, Belo Horizonte, MG, Brasil
| | - Vanessa Amaral Mendonça
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG,
Brasil
| | - Ana Cristina Rodrigues Lacerda
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade
de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG,
Brasil
| | - Maria Carmo Pereira Nunes
- Universidade Federal de Minas Gerais, Escola de Medicina, Curso de
pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | | | - Manoel Otávio da Costa Rocha
- Universidade Federal de Minas Gerais, Escola de Medicina, Curso de
pós-graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
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10
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Chambela MDC, Mediano MFF, Carneiro FM, Ferreira RR, Waghabi MC, Mendes VG, Oliveira LDS, de Holanda MT, de Sousa AS, da Costa AR, Xavier SS, da Silva GMS, Saraiva RM. Impact of pharmaceutical care on the quality of life of patients with heart failure due to chronic Chagas disease: Randomized clinical trial. Br J Clin Pharmacol 2019; 86:143-154. [PMID: 31659776 DOI: 10.1111/bcp.14152] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/20/2019] [Accepted: 10/03/2019] [Indexed: 12/15/2022] Open
Abstract
AIMS Chronic Chagas disease (ChD) has high morbimortality and loss in quality of life due to heart failure (HF). Pharmaceutical care (PC) optimizes clinical treatment and can improve quality of life in HF. We evaluated if PC improves quality of life of patients with ChD and HF. METHODS Single-blinded, randomized, controlled trial that assigned adult patients with ChD and HF (81 patients; 61 ± 11 years; 48% male) to PC (n = 40) or standard care (n = 41). Quality of life according to SF-36 and Minnesota living with HF questionnaires, incidence of drug-related problems (DRPs), and adherence to medical treatment were determined at baseline and at every 3 months for 1 year. Intention-to-treat analyses were performed by mixed linear model to verify the treatment effect on the changes of these variables throughout the intervention period. RESULTS Relative changes from baseline to 1 year of follow-up of the domains physical functioning (+16.6 vs -8.5; P < .001), role-physical (+34.0 vs +5.2; P = .01), general health (+19.4 vs -6.1; P < .001), vitality (+11.5 vs. -5.8; P = .003), social functioning (+7.5 vs -13.3; P = .002), and mental health (+9.0 vs -3.7; P = .006) of the SF-36 questionnaire and the Minnesota living with HF questionnaire score (-12.7 vs +4.8; P < .001) were superior in the PC group than in the standard care group. Adherence to medical treatment increased as early as after 3 months of follow-up and DRPs incidence decreased after 6 months of follow-up only in the PC group. CONCLUSIONS Patients with ChD and HF who received PC presented improved quality of life, decrease in DRP frequency, and increase in medication adherence.
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Affiliation(s)
- Mayara da Costa Chambela
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Fernanda Martins Carneiro
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Roberto Rodrigues Ferreira
- Laboratory of Functional Genomics and Bioinformatics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Mariana Caldas Waghabi
- Laboratory of Functional Genomics and Bioinformatics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Verônica Gonçalves Mendes
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Luciano de Souza Oliveira
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Andréa Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Andréa Rodrigues da Costa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Sérgio Salles Xavier
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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11
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Kono Y, Izawa H, Aoyagi Y, Ishikawa A, Sugiura T, Mori E, Ueda S, Fujiwara W, Hayashi M, Saitoh E. The difference in determinant factor of six-minute walking distance between sarcopenic and non-sarcopenic elderly patients with heart failure. J Cardiol 2019; 75:42-46. [PMID: 31387751 DOI: 10.1016/j.jjcc.2019.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/05/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND The purpose of this study was to identify the factors determining exercise capacity in elderly patients with heart failure (HF) with and without sarcopenia. METHODS We studied 186 consecutive patients with HF who met the criteria of being >60 years, with no physical disability. During hospitalization, we measured the 6-min walking distance (6MWD) and other physical functional parameters and evaluated echocardiographic and laboratory measurements indicating the severity of HF. First, we divided patients into two groups (the sarcopenia group and the nonsarcopenia group) according to the presence of sarcopenia defined as fulfilling more than or equal to two criteria-body mass index <18.5, walking speed <0.8m/s, and grip strength <26kg in males, or <18kg in females. Then the association between the 6MWD and the clinical variables mentioned above was analyzed by univariate and multiple logistic regression analyses. RESULTS The sarcopenia group comprised 77 patients (41.2%). In univariate analysis, age, grip strength, walking speed, and knee extensor muscle strength were significantly correlated with the 6MWD (p<0.05), whereas other clinical parameters were not. In multivariate analysis, walking speed was selected as an independent factor determining the 6MWD in both groups; however, knee extensor muscle strength was selected as an independent factor determining the 6MWD only in the sarcopenia group. CONCLUSION We demonstrated that knee extensor muscle strength was an independent factor determining exercise capacity-especially in elderly patients with HF with sarcopenia, and provided useful information in terms of exercise prescription.
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Affiliation(s)
- Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan.
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, Fujita Health University, Toyoake, Japan
| | - Ayako Ishikawa
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Tsubasa Sugiura
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Etsuko Mori
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Sayano Ueda
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, Fujita Health University, Toyoake, Japan
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12
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Kan C, Cao J, Hou J, Jing X, Zhu Y, Zhang J, Guo Y, Chen X. Correlation of miR-21 and BNP with pregnancy-induced hypertension complicated with heart failure and the diagnostic value. Exp Ther Med 2019; 17:3129-3135. [PMID: 30936985 PMCID: PMC6434261 DOI: 10.3892/etm.2019.7286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/29/2019] [Indexed: 02/06/2023] Open
Abstract
Correlation of miR-21 and B-type natriuretic peptide (BNP) with pregnancy-induced hypertension (PIH) complicated with heart failure and the diagnostic value was investigated. Sixty patients with PIH complicated with heart failure admitted to Affiliated Hospital of Chengde Medical University from July 2016 to July 2017 were enrolled as the experimental group, and 35 normal pregnant women as the control group. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) method was used to determine the expression level of plasma miR-21 expression level. An automatic biochemical analyzer was used to determine plasma BNP expression level. Spearmans correlation analysis was used for the correlation analysis of miR-21 and BNP. ROC curve was used for evaluating the diagnostic values of miR-21 and BNP for PIH complicated with heart failure. miR-21 and BNP expression levels were higher in patients with PIH complicated with heart failure than those in the normal individuals, and were increased in line with the heart failure grade (P<0.001). The plasma miR-21 expression was positively correlated with BNP in patients with PIH complicated with heart failure (r=0.685, P<0.001). Both miR-21 and BNP had higher diagnostic values for PIH complicated with heart failure, in the diagnosis, the best cut-off value [odds ratio (OR)] of miR-21 was 1.113, with an area under curve (AUC) of 0.889 and a 95% confidence interval (CI) of 82.05-95.76%; the OR of BNP was 123, with an AUC of 0.747 and a 95% CI of 64.95-84.38%. Blood pressure, six-minute walk test (6MWT), left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were independent risk factors for the occurrence of PIH complicated with heart failure (P<0.05). In conclusion, miR-21 and BNP, highly expressed in patients with PIH complicated with heart failure, are expected to become important biomarkers for diagnosing PIH complicated with heart failure and judging the degree of heart failure in the patients, and worthy of clinical popularization and application.
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Affiliation(s)
- Changli Kan
- Department of Obstetrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China
| | - Junjie Cao
- Department of Geriatrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China
| | - Jing Hou
- Department of Obstetrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China
| | - Xiangyang Jing
- Department of Obstetrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China
| | - Yanju Zhu
- Department of Obstetrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China
| | - Jinhuan Zhang
- Department of Obstetrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China
| | - Yanwei Guo
- Department of Obstetrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China
| | - Xuerong Chen
- Department of Obstetrics, Yanan Hospital Affiliated to Kunming Medical University, Kunming, Yunnan 650051, P.R. China
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13
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Santos-Filho JCL, Vieira MC, Xavier IGG, Maciel ER, Rodrigues Junior LF, Curvo EOV, Pereira IM, Quintana MSB, Sperandio da Silva GM, Veloso HH, Mendes FSNS, Hasslocher-Moreno AM, Sousa AS, do Brasil PEAA, Saraiva RM, Mediano MFF. Quality of life and associated factors in patients with chronic Chagas disease. Trop Med Int Health 2018; 23:1213-1222. [PMID: 30156352 DOI: 10.1111/tmi.13144] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate the quality of life (QoL) of patients with Chagas disease (CD) and the association between QoL domains and several clinical, socioeconomic and lifestyle characteristics of this population. METHODS Cross-sectional observational study conducted from March 2014 to March 2017 including a total of 361 outpatients followed at Evandro Chagas National Institute of Infectious Disease, Brazil. QoL was assessed using the Portuguese shorter version of the original WHO Quality of Life questionnaire (WHOQOL-BREF). Information about clinical CD presentation, presence of comorbidities, functional class, previous benznidazole treatment, socioeconomic profile and lifestyle was also obtained. RESULTS Environment and physical domains presented the worst QoL scores, while the social relationship domain presented the highest score. Multivariate regression analysis demonstrated that variables independently associated with QoL were functional class, sex, clinical presentation of CD, sleep duration, schooling, physical activity level, smoking, income per capita and residents by domicile. CONCLUSIONS The low socioeconomic status and the physical limitations imposed by the disease presented an important impact on the QoL reduction among CD patients, especially on environment and physical domains. Strategies to improve QoL among CD patients should be tailored and consider many different variables to maximise improvements not only of patients' physical but also of their mental health.
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Affiliation(s)
- João C L Santos-Filho
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcelo C Vieira
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, Brazil
| | - Isis G G Xavier
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Erica R Maciel
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Eduardo O V Curvo
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Iane M Pereira
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcel S B Quintana
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Henrique H Veloso
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fernanda S N S Mendes
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Andrea S Sousa
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Pedro E A A do Brasil
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Roberto M Saraiva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Mauro F F Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Physical Therapy Department, National Institute of Cardiology, Rio de Janeiro, Brazil
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